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Health, PCT Funding & Social Care

SIGOMA calls on the Government to:

  • Base funding for health on need
  • Base funding for Local Authority services on need
  • Remove the inadequacies and barriers in current funding regimes
  • Make improvements in partnership working

Improvements in health are key to many of the Government’s priorities. Prevention rather than the cure needs to be at the forefront of national policy and local practice.

Poor health within SIGOMA areas has an impact on every area of local service provision, creating greater dependency and need as well as increasing pressure on the resources available.

Progress is being made though and there is growing partnership work between primary care trusts and local services departments, helping to "join up" provision and understand the impacts of poor health on the ground.

SIGOMA now needs to harness the good work already undertaken to ensure that our local communities are better supported by both health and social care.

At the national level, the resourcing of local authority social service departments and health trusts needs to be complimentary to ensure funding is targeted at those areas in need of support. Overall, resources need to be adequate to deliver the joint health agenda. Failure to tackle the underlying health issues and causes of poor health because of inadequate funding will only store up problems for the future as well as encourage cost shunting and reduce trust between local agencies.

Social Care

The introduction of a new funding formula for the children and young adults elements of the overall Social Services formula in 2006/07 was a good step forward as they better reflected the needs of today. However, it was extremely disappointing that the Government implemented specific damping proposals for these two distinct blocks, minimising much needed changes to the pattern of social services funding.

SIGOMA therefore lobbied consistently and hard for the removal of this damping and therefore welcomed the decision to remove this perverse measure from 2008/09 onwards.

However, the continuing protection of authorities through the floor damping of overall grant still means that many are receiving more than they have been assessed as needing.

Primary Care Trust Funding

Compounding this lack of redistribution of resources for social services provision is the pace of change policy hampering similar progress on PCT funding. The current formula used by the Department of Health to allocate resources to PCT’s has two underlying aims:

  • to enable PCT’s to commission similar levels of healthcare for populations with similar healthcare need
  • to reduce avoidable health inequalities

The introduction of a separate element in the formula for PCT funding places more emphasis on reducing avoidable health inequalities. The new part of the formula uses Disability Free Life Expectancy, the length of time a person can expect to live their life free from disability, to measure health inequalities.

This change to the formula, along with other changes to recommended, has benefitted SIGOMA by acknowledging the current poor health our regions have compared to others.

Disability Free Life Expectancy by Region

Despite this new formula assessing our need as being greater than others, SIGOMA loses £1.2 billion of funding over the current spending review period, equating to a loss of nearly £100 per head in SIGOMA areas. In contrast, over the same period, London’s funding is protected to the tune of £2.4 billion, a funding boost of £320 per head of the population.

Over recent years, PCT, NHS and Health Services have received significant funding increases at record levels, and SIGOMA has not been excluded from this. In 2009/10, we saw increases of £1.15 billion and £1.20 billion in 2010/11. This increase compares broadly with the 2009/10 pace of change put in place by the Department of Health which states that average PCT growth will be 5.5% each year and that no PCT will be more than 6.2% under target by the end of 2010/11.

Despite this policy, SIGOMA authorities continue to be further away from target both in percentage terms and real cash terms.

Distance from Target (DFT)

PCT Funding08/09 Close DFT09/10 Close DFT10/11 Close DFT
South East£87m (1.5%)£254m (4.1%)£259m (4.0%)
London£474m (3.9%)£975m (8.1%)£999m (7.7%)
SIGOMA-£201m (-1.0%)-£524m (-2.3%)-£492 m (-2.0%)

Many of our areas are experiencing a double hit on the services that are most crucial for the most vulnerable in our communities. If we are to deliver the joined services we strive for, and improve the underlying health and social problems within our neighbourhoods, then the Government needs to move swiftly towards full implementation of its own funding targets.

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